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Textbook of Medical Physiology; with STUDENT CONSULT Access

by
Edition:
11th
ISBN13:

9780721602400

ISBN10:
0721602401
Format:
Hardcover
Pub. Date:
6/30/2005
Publisher(s):
SAUNDERS W B CO
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Summary

Physiology's classic text continues to uphold its rich tradition-presenting key physiology concepts in a remarkably clear and engaging manner. Guyton & Hall's Textbook of Medical Physiology covers all of the major systems in the human body, while emphasizing system interaction, homeostasis, and pathophysiology. This very readable, easy-to-follow, and thoroughly updated, 11th Edition features a new full-color layout, short chapters, clinical vignettes, and shaded summary tables that allow for easy comprehension of the material. The smart way to study! Elsevier titles with STUDENT CONSULT will help you master difficult concepts and study more efficiently in print and online! Perform rapid searches. Integrate bonus content from other disciplines. Download text to your handheld device. And a lot more. Each STUDENT CONSULT title comes with full text online, a unique image library, case studies, USMLE style questions, and online note-taking to enhance your learning experience. Presents short, easy-to-read chapters in keeping with the Guyton and Hall tradition. Provides shaded summary tables for easy reference. Includes clinical vignettes, which allow readers to see core concepts applied to real-life situations. Offers specific discussions of pathophysiology in most clinical areas of medicine. Ensures a strong grasp of physiology concepts through well-illustrated discussions of the most essential principles. Now in full color! Offers access to the full text and other valuable features online via the STUDENT CONSULT website. Uses full-color illustrations throughout, including 486 figures, 277 charts and graphs, 100 brand-new line drawings, and 36 ECGs. Features a new full-color design that makes information more engaging and even easier to read. Updated throughout to reflect the latest knowledge in the field.

Table of Contents

UNIT I Introduction to Physiology: The Cell and General Physiology
Functional Organization of the Human Body and Control of the ``Internal Environment''
3(8)
Cells as the Living Units of the Body
3(1)
Extracellular Fluid---The ``Internal Environment''
3(1)
``Homeostatic'' Mechanisms of the Major Functional Systems
4(2)
Homeostasis
4(1)
Extracellular Fluid Transport and Mixing System---The Blood Circulatory System
4(1)
Origin of Nutrients in the Extracellular Fluid
5(1)
Removal of Metabolic End Products
5(1)
Regulation of Body Functions
5(1)
Reproduction
6(1)
Control Systems of the Body
6(3)
Examples of Control Mechanisms
6(1)
Characteristics of Control Systems
7(2)
Summary---Automaticity of the Body
9(2)
The Cell and Its Functions
11(16)
Organization of the Cell
11(1)
Physical Structure of the Cell
12(6)
Membranous Structures of the Cell
12(2)
Cytoplasm and Its Organelles
14(3)
Nucleus
17(1)
Nuclear Membrane
17(1)
Nucleoli and Formation of Ribosomes
18(1)
Comparison of the Animal Cell with Precellular Forms of Life
18(1)
Functional Systems of the Cell
19(5)
Ingestion by the Cell---Endocytosis
19(1)
Digestion of Pinocytotic and Phagocytic Foreign Substances Inside the Cell---Function of the Lysosomes
20(1)
Synthesis and Formation of Cellular Structures by Endoplasmic Reticulum and Golgi Apparatus
20(2)
Extraction of Energy from Nutrients---Function of the Mitochondria
22(2)
Locomotion of Cells
24(3)
Ameboid Movement
24(1)
Cilia and Ciliary Movement
24(3)
Genetic Control of Protein Synthesis, Cell Function, and Cell Reproduction
27(18)
Genes in the Cell Nucleus
27(3)
Genetic Code
29(1)
The DNA Code in the Cell Nucleus Is Transferred to an RNA Code in the Cell Cytoplasm---The Process of Transcription
30(5)
Synthesis of RNA
30(1)
Assembly of the RNA Chain from Activated Nucleotides Using the DNA Strand as a Template---The Process of ``Transcription''
31(1)
Messenger RNA---The Codons
31(1)
Transfer RNA---The Anticodons
32(1)
Ribosomal RNA
33(1)
Formation of Proteins on the Ribosomes---The Process of ``Translation''
33(2)
Synthesis of Other Substances in the Cell
35(1)
Control of Gene Function and Biochemical Activity in Cells
35(2)
Genetic Regulation
35(1)
Control of Intracellular Function by Enzyme Regulation
36(1)
The DNA-Genetic System Also Controls Cell Reproduction
37(3)
Cell Reproduction Begins with Replication of DNA
37(1)
Chromosomes and Their Replication
38(1)
Cell Mitosis
38(1)
Control of Cell Growth and Cell Reproduction
39(1)
Cell Differentiation
40(1)
Apoptosis---Programmed Cell Death
40(1)
Cancer
40(5)
UNIT II Membrane Physiology, Nerve, and Muscle
Transport of Substances Through the Cell Membrane
45(12)
The Lipid Barrier of the Cell Membrane, and Cell Membrane Transport Proteins
45(1)
Diffusion
46(6)
Diffusion Through the Cell Membrane
46(1)
Diffusion Through Protein Channels, and ``Gating'' of These Channels
47(2)
Facilitated Diffusion
49(1)
Factors That Affect Net Rate of Diffusion
50(1)
Osmosis Across Selectively Permeable Membranes---``Net Diffusion'' of Water
51(1)
``Active Transport'' of Substances Through Membranes
52(5)
Primary Active Transport
53(1)
Secondary Active Transport---Co-Transport and Counter-Transport
54(1)
Active Transport Through Cellular Sheets
55(2)
Membrane Potentials and Action Potentials
57(15)
Basic Physics of Membrane Potentials
57(1)
Membrane Potentials Caused by Diffusion
57(1)
Measuring the Membrane Potential
58(1)
Resting Membrane Potential of Nerves
59(2)
Origin of the Normal Resting Membrane Potential
60(1)
Nerve Action Potential
61(3)
Voltage-Gated Sodium and Potassium Channels
62(2)
Summary of the Events That Cause the Action Potential
64(1)
Roles of Other Ions During the Action Potential
64(1)
Initiation of the Action Potential
65(1)
Propagation of the Action Potential
65(1)
Re-establishing Sodium and Potassium Ionic Gradients After Action Potentials Are Completed---Importance of Energy Metabolism
66(1)
Plateau in Some Action Potentials
66(1)
Rhythmicity of Some Excitable Tissues---Repetitive Discharge
67(1)
Special Characteristics of Signal Transmission in Nerve Trunks
68(1)
Excitation---The Process of Eliciting the Action Potential
69(1)
``Refractory Period'' After an Action Potential
70(1)
Recording Membrane Potentials and Action Potentials
70(2)
Inhibition of Excitability---``Stabilizers'' and Local Anesthetics
70(2)
Contraction of Skeletal Muscle
72(13)
Physiologic Anatomy of Skeletal Muscle
72(2)
Skeletal Muscle Fiber
72(2)
General Mechanism of Muscle Contraction
74(1)
Molecular Mechanism of Muscle Contraction
74(4)
Molecular Characteristics of the Contractile Filaments
75(2)
Effect of Amount of Actin and Myosin Filament Overlap on Tension Developed by the Contracting Muscle
77(1)
Relation of Velocity of Contraction to Load
78(1)
Energetics of Muscle Contraction
78(2)
Work Output During Muscle Contraction
78(1)
Sources of Energy for Muscle Contraction
79(1)
Characteristics of Whole Muscle Contraction
80(5)
Mechanics of Skeletal Muscle Contraction
81(1)
Remodeling of Muscle to Match Function
82(1)
Rigor Mortis
83(2)
Excitation of Skeletal Muscle: Neuromuscular Transmission and Excitation-Contraction Coupling
85(7)
Transmission of Impulses from Nerve Endings to Skeletal Muscle Fibers: The Neuromuscular Junction
85(3)
Secretion of Acetylcholine by the Nerve Terminals
85(3)
Molecular Biology of Acetyline Formation and Release
88(1)
Drugs That Enhance or Block Transmission at the Neuromuscular Junction
88(1)
Myasthenia Gravis
89(1)
Muscle Action Potential
89(1)
Spread of the Action Potential to the Interior of the Muscle Fiber by Way of ``Transverse Tubules''
89(1)
Excitation-Contraction Coupling
89(3)
Transverse Tubule-Sarcoplasmic Reticulum System
89(1)
Release of Calcium Ions by the Sarcoplasmic Reticulum
90(2)
Contraction and Excitation of Smooth Muscle
92(11)
Contraction of Smooth Muscle
92(3)
Types of Smooth Muscle
92(1)
Contractile Mechanism in Smooth Muscle
93(2)
Regulation of Contraction by Calcium Ions
95(1)
Nervous and Hormonal Control of Smooth Muscle Contraction
95(8)
Neuromuscular Junctions of Smooth Muscle
95(1)
Membrane Potentials and Action Potentials in Smooth Muscle
96(2)
Effect of Local Tissue Factors and Hormones to Cause Smooth Muscle Contraction Without Action Potentials
98(1)
Source of Calcium Ions That Cause Contraction (1) Through the Cell Membrane and (2) from the Sarcoplasmic Reticulum
99(4)
UNIT III The Heart
Heart Muscle; The Heart as a Pump and Function of the Heart Valves
103(13)
Physiology of Cardiac Muscle
103(3)
Physiologic Anatomy of Cardiac Muscle
103(1)
Action Potentials in Cardiac Muscle
104(2)
The Cardiac Cycle
106(3)
Diastole and Systole
106(1)
Relationship of the Electrocardiogram to the Cardiac Cycle
107(1)
Function of the Atria as Primer Pumps
107(1)
Function of the Ventricles as Pumps
108(1)
Function of the Valves
109(1)
Aortic Pressure Curve
109(1)
Relationship of the Heart Sounds to Heart Pumping
109(1)
Work Output of the Heart
110(1)
Graphical Analysis of Ventricular Pumping
110(1)
Chemical Energy Required for Cardiac Contraction: Oxygen Utilization by the Heart
111(1)
Regulation of Heart Pumping
111(5)
Intrinsic Regulation of Heart Pumping---The Frank-Starling Mechanism
111(2)
Effect of Potassium and Calcium Ions on Heart Function
113(1)
Effect of Temperature on Heart Function
114(1)
Increasing the Arterial Pressure Load (up to a Limit) Does Not Decrease the Cardiac Output
114(2)
Rhythmical Excitation of the Heart
116(7)
Specialized Excitatory and Conductive System of the Heart
116(4)
Sinus (Sinoatrial) Node
116(2)
Internodal Pathways and Transmission of the Cardiac Impulse Through the Atria
118(1)
Atrioventricular Node, and Delay of Impulse Conduction from the Atria to the Ventricles
118(1)
Rapid Transmission in the Ventricular Purkinje System
119(1)
Transmission of the Cardiac Impulse in the Ventricular Muscle
119(1)
Summary of the Spread of the Cardiac Impulse Through the Heart
120(1)
Control of Excitation and Conduction in the Heart
120(3)
The Sinus Node as the Pacemaker of the Heart
120(1)
Role of the Purkinje System in Causing Synchronous Contraction of the Ventricular Muscle
121(1)
Control of Heart Rhythmicity and Impulse Conduction by the Cardiac Nerves: The Sympathetic and Parasympathetic Nerves
121(2)
The Normal Electrocardiogram
123(8)
Characteristics of the Normal Electrocardiogram
123(3)
Depolarization Waves Versus Repolarization Waves
123(2)
Relationship of Atrial and Ventricular Contraction to the Waves of the Electrocardiogram
125(1)
Voltage and Time Calibration of the Electrocardiogram
125(1)
Methods for Recording Electrocardiograms
126(1)
Pen Recorder
126(1)
Flow of Current Around the Heart During the Cardiac Cycle
126(1)
Recording Electrical Potentials from a Partially Depolarized Mass of Syncytial Cardiac Muscle
126(1)
Flow of Electrical Currents in the Chest Around the Heart
126(1)
Electrocardiographic Leads
127(4)
Three Bipolar Limb Leads
127(2)
Chest Leads (Precordial Leads)
129(1)
Augmented Unipolar Limb Leads
129(2)
Electrocardiographic Interpretation of Cardiac Muscle and Coronary Blood Flow Abnormalities: Vectorial Analysis
131(16)
Principles of Vectorial Analysis of Electrocardiograms
131(3)
Use of Vectors to Represent Electrical Potentials
131(1)
Direction of a Vector is Denoted in Terms of Degrees
131(1)
Axis for Each Standard Bipolar Lead and Each Unipolar Limb Lead
132(1)
Vectorial Analysis of Potentials Recorded in Different Leads
133(1)
Vectorial Analysis of the Normal Electrocardiogram
134(3)
Vectors That Occur at Successive Intervals During Depolarization of the Ventricles---The QRS Complex
134(1)
Electrocardiogram During Repolarization---The T Wave
134(2)
Depolarization of the Atria---The P Wave
136(1)
Vectorcardiogram
136(1)
Mean Electrical Axis of the Ventricular QRS---And Its Significance
137(3)
Determining the Electrical Axis from Standard Lead Electrocardiograms
137(1)
Abnormal Ventricular Conditions That Cause Axis Deviation
138(2)
Conditions That Cause Abnormal Voltages of the QRS Complex
140(1)
Increased Voltage in the Standard Bipolar Limb Leads
140(1)
Decreased Voltage of the Electrocardiogram
140(1)
Prolonged and Bizarre Patterns of the QRS Complex
141(1)
Prolonged QRS Complex as a Result of Cardiac Hypertrophy or Dilatation
141(1)
Prolonged QRS Complex Resulting from Purkinje System Blocks
141(1)
Conditions That Cause Bizarre QRS Complexes
141(1)
Current of Injury
141(4)
Effect of Current of Injury on the QRS Complex
141(1)
The J Point---The Zero Reference Potential for Analyzing Current of Injury
142(1)
Coronary Ischemia as a Cause of Injury Potential
143(2)
Abnormalities in the T Wave
145(2)
Effect of Slow Conduction of the Depolarization Wave on the Characteristics of the T Wave
145(1)
Shortened Depolarization in Portions of the Ventricular Muscle as a Cause of T Wave Abnormalities
145(2)
Cardiac Arrhythmias and Their Electrocardiographic Interpretation
147(14)
Abnormal Sinus Rhythms
147(1)
Tachycardia
147(1)
Bradycardia
147(1)
Sinus Arrhythmia
148(1)
Abnormal Rhythms That Result from Block of Heart Signals Within the Intracardiac Conduction Pathways
148(2)
Sinoatrial Block
148(1)
Atrioventricular Block
148(1)
Incomplete Atrioventricular Heart Block
149(1)
Incomplete Intraventricular Block---Electrical Alternans
150(1)
Premature Contractions
150(1)
Premature Atrial Contractions
150(1)
A-V Nodal or A-V Bundle Premature Contractions
150(1)
Premature Ventricular Contractions
151(1)
Paroxysmal Tachycardia
151(1)
Atrial Paroxysmal Tachycardia
152(1)
Ventricular Paroxysmal Tachycardia
152(1)
Ventricular Fibrillation
152(3)
Phenomenon of Re-entry---``Circus Movements'' as the Basis for Ventricular Fibrillation
153(1)
Chain Reaction Mechanism of Fibrillation
153(1)
Electrocardiogram in Ventricular Fibrillation
154(1)
Electroshock Defibrillation of the Ventricle
154(1)
Hand Pumping of the Heart (Cardiopulmonary Resuscitation) as an Aid to Defibrillation
155(1)
Atrial Fibrillation
155(1)
Atrial Flutter
156(1)
Cardiac Arrest
156(5)
UNIT IV The Circulation
Overview of the Circulation; Medical Physics of Pressure, Flow, and Resistance
161(10)
Physical Characteristics of the Circulation
161(2)
Basic Theory of Circulatory Function
163(1)
Interrelationships Among Pressure, Flow, and Resistance
164(7)
Blood Flow
164(2)
Blood Pressure
166(1)
Resistance to Blood Flow
167(3)
Effects of Pressure on Vascular Resistance and Tissue Blood Flow
170(1)
Vascular Distensibility and Functions of the Arterial and Venous Systems
171(10)
Vascular Distensibility
171(2)
Vascular Compliance (or Vascular Capacitance)
171(1)
Volume-Pressure Curves of the Arterial and Venous Circulations
172(1)
Arterial Pressure Pulsations
173(3)
Transmission of Pressure Pulses to the Peripheral Arteries
174(1)
Clinical Methods for Measuring Systolic and Diastolic Pressures
175(1)
Veins and Their Functions
176(5)
Venous Pressures---Right Atrial Pressure (Central Venous Pressure) and Peripheral Venous Pressures
176(3)
Blood Reservoir Function of the Veins
179(2)
The Microcirculation and the Lymphatic System: Capillary Fluid Exchange, Interstitial Fluid, and Lymph Flow
181(14)
Structure of the Microcirculation and Capillary System
181(1)
Flow of Blood in the Capillaries---Vasomotion
182(1)
Average Function of the Capillary System
183(1)
Exchange of Water, Nutrients, and Other Substances Between the Blood and Interstitial Fluid
183(1)
Diffusion Through the Capillary Membrane
183(1)
The Interstitium and Interstitial Fluid
184(1)
Fluid Filtration Across Capillaries Is Determined by Hydrostatic and Colloid Osmotic Pressures, and Capillary Filtration Coefficient
185(5)
Capillary Hydrostatic Pressure
186(1)
Interstitial Fluid Hydrostatic Pressure
187(1)
Plasma Colloid Osmotic Pressure
188(1)
Interstitial Fluid Colloid Osmotic Pressure
188(1)
Exchange of Fluid Volume Through the Capillary Membrane
189(1)
Starling Equilibrium for Capillary Exchange
189(1)
Lymphatic System
190(5)
Lymph Channels of the Body
190(1)
Formation of Lymph
191(1)
Rate of Lymph Flow
192(1)
Role of the Lymphatic System in Controlling Interstitial Fluid Protein Concentration, Interstitial Fluid Volume, and Interstitial Fluid Pressure
193(2)
Local and Humoral Control of Blood Flow by the Tissues
195(9)
Local Control of Blood Flow in Response to Tissue Needs
195(1)
Mechanisms of Blood Flow Control
196(5)
Acute Control of Local Blood Flow
196(4)
Long-Term Blood Flow Regulation
200(1)
Development of Collateral Circulation---A Phenomenon of Long-Term Local Blood Flow Regulation
201(1)
Humoral Control of the Circulation
201(3)
Vasoconstrictor Agents
201(1)
Vasodilator Agents
202(1)
Vascular Control by Ions and Other Chemical Factors
202(2)
Nervous Regulation of the Circulation, and Rapid Control of Arterial Pressure
204(12)
Nervous Regulation of the Circulation
204(4)
Autonomic Nervous System
204(4)
Role of the Nervous System in Rapid Control of Arterial Pressure
208(5)
Increase in Arterial Pressure During Muscle Exercise and Other Types of Stress
208(1)
Reflex Mechanisms for Maintaining Normal Arterial Pressure
209(3)
Central Nervous System Ischemic Response---Control of Arterial Pressure by the Brain's Vasomotor Center in Response to Diminished Brain Blood Flow
212(1)
Special Features of Nervous Control of Arterial Pressure
213(3)
Role of the Skeletal Nerves and Skeletal Muscles in Increasing Cardiac Output and Arterial Pressure
213(1)
Respiratory Waves in the Arterial Pressure
214(1)
Arterial Pressure ``Vasomotor'' Waves---Oscillation of Pressure Reflex Control Systems
214(2)
Dominant Role of the Kidney in Long-Term Regulation of Arterial Pressure and in Hypertension: The Integrated System for Pressure Control
216(16)
Renal-Body Fluid System for Arterial Pressure Control
216(7)
Quantitation of Pressure Diuresis as a Basis for Arterial Pressure Control
217(3)
Chronic Hypertension (High Blood Pressure) Is Caused by Impaired Renal Fluid Excretion
220(3)
The Renin-Angiotensin System: Its Role In Pressure Control and in Hypertension
223(7)
Components of the Renin-Angiotensin System
223(3)
Types of Hypertension in Which Angiotensin Is Involved: Hypertension Caused by a Renin-Secreting Tumor or by Infusion of Angiotensin II
226(1)
Other Types of Hypertension Caused by Combinations of Volume Loading and Vasoconstriction
227(1)
``Primary (Essential) Hypertension''
228(2)
Summary of the Integrated, Multifaceted System for Arterial Pressure Regulation
230(2)
Cardiac Output, Venous Return, and Their Regulation
232(14)
Normal Values for Cardiac Output at Rest and During Activity
232(1)
Control of Cardiac Output by Venous Return---Role of the Frank-Starling Mechanism of the Heart
232(4)
Cardiac Output Regulation Is the Sum of Blood Flow Regulation in All the Local Tissues of the Body---Tissue Metabolism Regulates Most Local Blood Flow
233(1)
The Heart Has Limits for the Cardiac Output That It Can Achieve
234(1)
What Is the Role of the Nervous System in Controlling Cardiac Output?
235(1)
Pathologically High and Pathologically Low Cardiac Outputs
236(7)
High Cardiac Output Caused by Reduced Total Peripheral Resistance
236(1)
Low Cardiac Output
237(1)
A More Quantitative Analysis of Cardiac Output Regulation
237(1)
Cardiac Output Curves Used in the Quantitative Analysis
237(1)
Venous Return Curves
238(3)
Analysis of Cardiac Output and Right Atrial Pressure, Using Simultaneous Cardiac Output and Venous Return Curves
241(2)
Methods for Measuring Cardiac Output
243(3)
Pulsatile Output of the Heart as Measured by an Electromagnetic or Ultrasonic Flowmeter
243(1)
Measurement of Cardiac Output Using the Oxygen Fick Principle
244(1)
Indicator Dilution Method for Measuring Cardiac Output
244(2)
Muscle Blood Flow and Cardiac Output During Exercise; the Coronary Circulation and Ischemic Heart Disease
246(12)
Blood Flow in Skeletal Muscle and Blood Flow Regulation During Exercise
246(3)
Rate of Blood Flow Through the Muscles
246(1)
Control of Blood Flow Through the Skeletal Muscles
247(1)
Total Body Circulatory Readjustments During Exercise
247(2)
Coronary Circulation
249(9)
Physiologic Anatomy of the Coronary Blood Supply
249(1)
Normal Coronary Blood Flow
249(1)
Control of Coronary Blood Flow
250(1)
Special Features of Cardiac Muscle Metabolism
251(1)
Ischemic Heart Disease
252(1)
Causes of Death After Acute Coronary Occlusion
253(1)
Stages of Recovery from Acute Myocardial Infarction
254(1)
Function of the Heart After Recovery from Myocardial Infarction
255(1)
Pain in Coronary Heart Disease
255(1)
Surgical Treatment of Coronary Disease
256(2)
Cardiac Failure
258(11)
Dynamics of the Circulation in Cardiac Failure
258(4)
Acute Effects of Moderate Cardiac Failure
258(1)
Chronic Stage of Failure---Fluid Retention Helps to Compensate Cardiac Output
259(1)
Summary of the Changes That Occur After Acute Cardiac Failure---``Compensated Heart Failure''
260(1)
Dynamics of Severe Cardiac Failure---Decompensated Heart Failure
260(2)
Unilateral Left Heart Failure
262(1)
Low-Output Cardiac Failure---Cardiogenic Shock
262(1)
Edema in Patients with Cardiac Failure
263(1)
Cardiac Reserve
264(5)
Quantitative Graphical Method for Analysis of Cardiac Failure
265(4)
Heart Valves and Heart Sounds; Dynamics of Valvular and Congenital Heart Defects
269(9)
Heart Sounds
269(3)
Normal Heart Sounds
269(2)
Valvular Lesions
271(1)
Abnormal Circulatory Dynamics in Valvular Heart Disease
272(2)
Dynamics of the Circulation in Aortic Stenosis and Aortic Regurgitation
272(1)
Dynamics of Mitral Stenosis and Mitral Regurgitation
273(1)
Circulatory Dynamics During Exercise in Patients with Valvular Lesions
273(1)
Abnormal Circulatory Dynamics in Congenital Heart Defects
274(2)
Patent Ductus Arteriosus---A Left-to-Right Shunt
274(1)
Tetralogy of Fallot---A Right-to-Left Shunt
274(2)
Causes of Congenital Anomalies
276(1)
Use of Extracorporeal Circulation During Cardiac Surgery
276(1)
Hypertrophy of the Heart in Valvular and Congenital Heart Disease
276(2)
Circulatory Shock and Physiology of Its Treatment
278(13)
Physiologic Causes of Shock
278(1)
Circulatory Shock Caused by Decreased Cardiac Output
278(1)
Circulatory Shock That Occurs Without Diminished Cardiac Output
278(1)
What Happens to the Arterial Pressure in Circulatory Shock?
279(1)
Tissue Deterioration Is the End Result of Circulatory Shock, Whatever the Cause
279(1)
Stages of Shock
279(1)
Shock Caused by Hypovolemia---Hemorrhagic Shock
279(6)
Relationship of Bleeding Volume to Cardiac Output and Arterial Pressure
279(1)
Progressive and Nonprogressive Hemorrhagic Shock
280(4)
Irreversible Shock
284(1)
Hypovolemic Shock Caused by Plasma Loss
284(1)
Hypovolemic Shock Caused by Trauma
285(1)
Neurogenic Shock---Increased Vascular Capacity
285(1)
Anaphylactic Shock and Histamine Shock
285(1)
Septic Shock
286(1)
Physiology of Treatment in Shock
286(1)
Replacement Therapy
286(1)
Treatment of Shock with Sympathomimetic Drugs---Sometimes Useful, Sometimes Not
287(1)
Other Therapy
287(1)
Circulatory Arrest
287(4)
Effect of Circulatory Arrest on the Brain
287(4)
UNIT V The Body Fluids and Kidneys
The Body Fluid Compartments: Extracellular and Intracellular Fluids; Interstitial Fluid and Edema
291(16)
Fluid Intake and Output Are Balanced During Steady-State Conditions
291(1)
Daily Intake of Water
291(1)
Daily Loss of Body Water
291(1)
Body Fluid Compartments
292(1)
Intracellular Fluid Compartment
293(1)
Extracellular Fluid Compartment
293(1)
Blood Volume
293(1)
Constituents of Extracellular and Intracellular Fluids
293(2)
Ionic Composition of Plasma and Interstitial Fluid Is Similar
293(2)
Important Constituents of the Intracellular Fluid
295(1)
Measurement of Fluid Volumes in the Different Body Fluid Compartments---The Indicator-Dilution Principle
295(1)
Determination of Volumes of Specific Body Fluid Compartments
295(1)
Regulation of Fluid Exchange and Osmotic Equilibrium Between Intracellular and Extracellular Fluid
296(1)
Basic Principles of Osmosis and Osmotic Pressure
296(2)
Osmotic Equilibrium Is Maintained Between Intracellular and Extracellular Fluids
298(1)
Volume and Osmolality of Extracellular and Intracellular Fluids in Abnormal States
299(2)
Effect of Adding Saline Solution to the Extracellular Fluid
299(2)
Glucose and Other Solutions Administered for Nutritive Purposes
301(1)
Clinical Abnormalities of Fluid Volume Regulation: Hyponatremia and Hypernatremia
301(1)
Causes of Hyponatremia: Excess Water or Loss of Sodium
301(1)
Causes of Hypernatremia: Water Loss or Excess Sodium
302(1)
Edema: Excess Fluid in the Tissues
302(3)
Intracellular Edema
302(1)
Extracellular Edema
302(1)
Summary of Causes of Extracellular Edema
303(1)
Safety Factors That Normally Prevent Edema
304(1)
Fluids in the ``Potential Spaces'' of the Body
305(2)
Urine Formation by the Kidneys: I. Glomerular Filtration, Renal Blood Flow, and Their Control
307(20)
Multiple Functions of the Kidneys in Homeostasis
307(1)
Physiologic Anatomy of the Kidneys
308(3)
General Organization of the Kidneys and Urinary Tract
308(1)
Renal Blood Supply
309(1)
The Nephron Is the Functional Unit of the Kidney
310(1)
Micturition
311(1)
Physiologic Anatomy and Nervous Connections of the Bladder
311(1)
Transport of Urine from the Kidney Through the Ureters and into the Bladder
312(1)
Innervation of the Bladder
312(1)
Filling of the Bladder and Bladder Wall Tone; the Cystometrogram
312(1)
Micturition Reflex
313(1)
Facilitation or Inhibition of Micturition by the Brain
313(1)
Abnormalities of Micturition
313(1)
Urine Formation Results from Glomerular Filtration, Tubular Reabsorption, and Tubular Secretion
314(2)
Filtration, Reabsorption, and Secretion of Different Substances
315(1)
Glomerular Filtration---The First Step in Urine Formation
316(1)
Composition of the Glomerular Filtrate
316(1)
GFR Is About 20 Per Cent of the Renal Plasma Flow
316(1)
Glomerular Capillary Membrane
316(1)
Determinants of the GFR
317(3)
Increased Glomerular Capillary Filtration Coefficient Increases GFR
318(1)
Increased Bowman's Capsule Hydrostatic Pressure Decreases GFR
318(1)
Increased Glomerular Capillary Colloid Osmotic Pressure Decreases GFR
318(1)
Increased Glomerular Capillary Hydrostatic Pressure Increases GFR
319(1)
Renal Blood Flow
320(1)
Renal Blood Flow and Oxygen Consumption
320(1)
Determinants of Renal Blood Flow
320(1)
Blood Flow in the Vasa Recta of the Renal Medulla Is Very Low Compared with Flow in the Renal Cortex
321(1)
Physiologic Control of Glomerular Filtration and Renal Blood Flow
321(2)
Sympathetic Nervous System Activation Decreases GFR
321(1)
Hormonal and Autacoid Control of Renal Circulation
322(1)
Autoregulation of GFR and Renal Blood Flow
323(4)
Importance of GFR Autoregulation in Preventing Extreme Changes in Renal Excretion
323(1)
Role of Tubuloglomerular Feedback in Autoregulation of GFR
323(2)
Myogenic Autoregulation of Renal Blood Flow and GFR
325(1)
Other Factors That Increase Renal Blood Flow and GFR: High Protein Intake and Increased Blood Glucose
325(2)
Urine Formation by the Kidneys: II. Tubular Processing of the Glomerular Filtrate
327(21)
Reabsorption and Secretion by the Renal Tubules
327(1)
Tubular Reabsorption Is Selective and Quantitatively Large
327(1)
Tubular Reabsorption Includes Passive and Active Mechanisms
328(5)
Active Transport
328(4)
Passive Water Reabsorption by Osmosis Is Coupled Mainly to Sodium Reabsorption
332(1)
Reabsorption of Chloride, Urea, and Other Solutes by Passive Diffusion
332(1)
Reabsorption and Secretion Along Different Parts of the Nephron
333(6)
Proximal Tubular Reabsorption
333(1)
Solute and Water Transport in the Loop of Henle
334(2)
Distal Tubule
336(1)
Late Distal Tubule and Cortical Collecting Tubule
336(1)
Medullary Collecting Duct
337(1)
Summary of Concentrations of Different Solutes in the Different Tubular Segments
338(1)
Regulation of Tubular Reabsorption
339(4)
Glomerulotubular Balance---The Ability of the Tubules to Increase Reabsorption Rate in Response to Increased Tubular Load
339(1)
Peritubular Capillary and Renal Interstitial Fluid Physical Forces
339(2)
Effect of Arterial Pressure on Urine Output---The Pressure-Natriuresis and Pressure-Diuresis Mechanisms
341(1)
Hormonal Control of Tubular Reabsorption
342(1)
Sympathetic Nervous System Activation Increases Sodium Reabsorption
343(1)
Use of Clearance Methods to Quantify Kidney Function
343(5)
Inulin Clearance Can Be Used to Estimate GFR
344(1)
Creatine Clearance and Plasma Creatinine Clearance Can Be Used to Estimate GFR
344(1)
PAH Clearance Can Be Used to Estimate Renal Plasma Flow
345(1)
Filtration Fraction Is Calculated from GFR Divided by Renal Plasma Flow
346(1)
Calculation of Tubular Reabsorption or Secretion from Renal Clearance
346(2)
Regulation of Extracellular Fluid Osmolarity and Sodium Concentration
348(17)
The Kidneys Excrete Excess Water by Forming a Dilute Urine
348(2)
Antidiuretic Hormone Controls Urine Concentration
348(1)
Renal Mechanisms for Excreting a Dilute Urine
349(1)
The Kidneys Conserve Water by Excreting a Concentrated Urine
350(7)
Obligatory Urine Volume
350(1)
Requirements for Excreting a Concentrated Urine---High ADH Levels and Hyperosmotic Renal Medulla
350(1)
Countercurrent Mechanism Produces a Hyperosmotic Renal Medullary Interstitium
351(1)
Role of Distal Tubule and Collecting Ducts in Excreting a Concentrated Urine
352(1)
Urea Contributes to Hyperosmotic Renal Medullary Interstitium and to a Concentrated Urine
353(1)
Countercurrent Exchange in the Vasa Recta Preserves Hyperosmolarity of the Renal Medulla
354(1)
Summary of Urine Concentrating Mechanism and Changes in Osmolarity in Different Segments of the Tubules
355(2)
Quantifying Renal Urine Concentration and Dilution: ``Free Water'' and Osmolar Clearances
357(1)
Disorders of Urinary Concentrating Ability
357(1)
Control of Extracellular Fluid Osmolarity and Sodium Concentration
358(1)
Estimating Plasma Osmolarity from Plasma Sodium Concentration
358(1)
Osmoreceptor-ADH Feedback System
358(3)
ADH Synthesis in Supraoptic and Paraventricular Nuclei of the Hypothalamus and ADH Release from the Posterior Pituitary
359(1)
Cardiovascular Reflex Stimulation of ADH Release by Decreased Arterial Pressure and/or Decreased Blood Volume
360(1)
Quantitative Importance of Cardiovascular Reflexes and Osmolarity in Stimulating ADH Secretion
360(1)
Other Stimuli for ADH Secretion
360(1)
Role of Thirst in Controlling Extracellular Fluid Osmolarity and Sodium Concentration
361(2)
Central Nervous System Centers for Thirst
361(1)
Stimuli for Thirst
361(1)
Threshold for Osmolar Stimulus of Drinking
362(1)
Integrated Responses of Osmoreceptor-ADH and Thirst Mechanisms in Controlling Extracellular Fluid Osmolarity and Sodium Concentration
362(1)
Role of Angiotensin II and Aldosterone in Controlling Extracellular Fluid Osmolarity and Sodium Concentration
362(1)
Salt-Appetite Mechanism for Controlling Extracellular Fluid Sodium Concentration and Volume
363(2)
Renal Regulation of Potassium, Calcium, Phosphate, and Magnesium; Integration of Renal Mechanisms for Control of Blood Volume and Extracellular Fluid Volume
365(18)
Regulation of Potassium Excretion and Potassium Concentration in Extracellular Fluid
365(6)
Regulation of Internal Potassium Distribution
366(1)
Overview of Renal Potassium Excretion
367(1)
Potassium Secretion by Principal Cells of Late Distal and Cortical Collecting Tubules
367(1)
Summary of Factors That Regulate Potassium Secretion: Plasma Potassium Concentration, Aldosterone, Tubular Flow Rate, and Hydrogen Ion Concentration
368(3)
Control of Renal Calcium Excretion and Extracellular Calcium Ion Concentration
371(2)
Control of Calcium Excretion by the Kidneys
372(1)
Regulation of Renal Phosphate Excretion
372(1)
Control of Renal Magnesium Excretion and Extracellular Magnesium Ion Concentration
373(1)
Integration of Renal Mechanisms for Control of Extracellular Fluid
373(1)
Sodium Excretion Is Precisely Matched to Intake Under Steady-State Conditions
373(1)
Sodium Excretion Is Controlled by Altering Glomerular Filtration or Tubular Sodium Reabsorption Rates
374(1)
Importance of Pressure Natriuresis and Pressure Diuresis in Maintaining Body Sodium and Fluid Balance
374(2)
Pressure Natriuresis and Diuresis Are Key Components of a Renal-Body Fluid Feedback for Regulating Body Fluid Volumes and Arterial Pressure
375(1)
Precision of Blood Volume and Extracellular Fluid Volume Regulation
376(1)
Distribution of Extracellular Fluid Between the Interstitial Spaces and Vascular System
376(1)
Nervous and Hormonal Factors Increase the Effectiveness of Renal-Body Fluid Feedback Control
377(3)
Sympathetic Nervous System Control of Renal Excretion: Arterial Baroreceptor and Low-Pressure Stretch Receptor Reflexes
377(1)
Role of Angiotensin II in Controlling Renal Excretion
377(1)
Role of Aldosterone in Controlling Renal Excretion
378(1)
Role of ADH in Controlling Renal Water Excretion
379
Role of Atrial Natriuretic Peptide in Controlling Renal Excretion
378(2)
Integrated Responses to Changes in Sodium Intake
380(1)
Conditions That Cause Large Increases in Blood Volume and Extracellular Fluid Volume
380(1)
Increased Blood Volume and Extracellular Fluid Volume Caused by Heart Diseases
380(1)
Increased Blood Volume Caused by Increased Capacity of Circulation
380(1)
Conditions That Cause Large Increases in Extracellular Fluid Volume but with Normal Blood Volume
381(2)
Nephrotic Syndrome---Loss of Plasma Proteins in Urine and Sodium Retention by the Kidneys
381(1)
Liver Cirrhosis---Decreased Synthesis of Plasma Proteins by the Liver and Sodium Retention by the Kidneys
381(2)
Regulation of Acid-Base Balance
383(19)
Hydrogen Ion Concentration Is Precisely Regulated
383(1)
Acids and Bases---Their Definitions and Meanings
383(1)
Defenses Against Changes in Hydrogen Ion Concentration: Buffers, Lungs, and Kidneys
384(1)
Buffering of Hydrogen Ions in the Body Fluids
385(1)
Bicarbonate Buffer System
385(2)
Quantitative Dynamics of the Bicarbonate Buffer System
385(2)
Phosphate Buffer System
387(1)
Proteins: Important Intracellular Buffers
387(1)
Respiratory Regulation of Acid-Base Balance
388(2)
Pulmonary Expiration of CO2 Balances Metabolic Formation of CO2
388(1)
Increasing Alveolar Ventilation Decreases Extracellular Fluid Hydrogen Ion Concentration and Raises pH
388(1)
Increased Hydrogen Ion Concentration Stimulates Alveolar Ventilation
389(1)
Renal Control of Acid-Base Balance
390(1)
Secretion of Hydrogen Ions and Reabsorption of Bicarbonate Ions by the Renal Tubules
390(2)
Hydrogen Ions Are Secreted by Secondary Active Transport in the Early Tubular Segments
391(1)
Filtered Bicarbonate Ions Are Reabsorbed by Interaction with Hydrogen Ions in the Tubules
391(1)
Primary Active Secretion of Hydrogen Ions in the Intercalated Cells of Late Distal and Collecting Tubules
392(1)
Combination of Excess Hydrogen Ions with Phosphate and Ammonia Buffers in the Tubule---A Mechanism for Generating ``New'' Bicarbonate Ions
392(2)
Phosphate Buffer System Carries Excess Hydrogen Ions into the Urine and Generates New Bicarbonate
393(1)
Excretion of Excess Hydrogen Ions and Generation of New Bicarbonate by the Ammonia Buffer System
393(1)
Quantifying Renal Acid-Base Excretion
394(2)
Regulation of Renal Tubular Hydrogen Ion Secretion
395(1)
Renal Correction of Acidosis---Increased Excretion of Hydrogen Ions and Addition of Bicarbonate Ions to the Extracellular Fluid
396(1)
Acidosis Decreases the Ratio of HCO3-/H+ in Renal Tubular Fluid
396(1)
Renal Correction of Alkalosis---Decreased Tubular Secretion of Hydrogen Ions and Increased Excretion of Bicarbonate Ions
396(1)
Alkalosis Increases the Ratio of HCO3-/H+ in Renal Tubular Fluid
396(1)
Clinical Causes of Acid-Base Disorders
397(1)
Respiratory Acidosis Is Caused by Decreased Ventilation and Increased PCO2
397(1)
Respiratory Alkalosis Results from Increased Ventilation and Decreased PCO2
397(1)
Metabolic Acidosis Results from Decreased Extracellular Fluid Bicarbonate Concentration
397(1)
Treatment of Acidosis or Alkalosis
398(1)
Clinical Measurements and Analysis of Acid-Base Disorders
398(4)
Complex Acid-Base Disorders and Use of the Acid-Base Nomogram for Diagnosis
399(1)
Use of Anion Gap to Diagnose Acid-Base Disorders
400(2)
Kidney Diseases and Diuretics
402(17)
Diuretics and Their Mechanisms of Action
402(2)
Osmotic Diuretics Decrease Water Reabsorption by Increasing Osmotic Pressure of Tubular Fluid
402(1)
``Loop'' Diuretics Decrease Active Sodium-Chloride-Potassium Reabsorption in the Thick Ascending Loop of Henle
403(1)
Thiazide Diuretics Inhibit Sodium-Chloride Reabsorption in the Early Distal Tubule
404(1)
Carbonic Anhydrase Inhibitors Block Sodium-Bicarbonate Reabsorption in the Proximal Tubules
404(1)
Competitive Inhibitors of Aldosterone Decrease Sodium Reabsorption from and Potassium Secretion into the Cortical Collecting Tubule
404(1)
Diuretics That Block Sodium Channels in the Collecting Tubules Decrease Sodium Reabsorption
404(1)
Kidney Diseases
404(1)
Acute Renal Failure
404(2)
Prerenal Acute Renal Failure Caused by Decreased Blood Flow to the Kidney
405(1)
Intrarenal Acute Renal Failure Caused by Abnormalities within the Kidney
405(1)
Postrenal Acute Renal Failure Caused by Abnormalities of the Lower Urinary Tract
406(1)
Physiologic Effects of Acute Renal Failure
406(1)
Chronic Renal Failure: An Irreversible Decrease in the Number of Functional Nephrons
406(7)
Vicious Circle of Chronic Renal Failure Leading to End-Stage Renal Disease
407(1)
Injury to the Renal Vasculature as a Cause of Chronic Renal Failure
408(1)
Injury to the Glomeruli as a Cause of Chronic Renal Failure---Glomerulonephritis
408(1)
Injury to the Renal Interstitium as a Cause of Chronic Renal Failure---Pyelonephritis
409(1)
Nephrotic Syndrome---Excretion of Protein in the Urine Because of Increased Glomerular Permeability
409(1)
Nephron Function in Chronic Renal Failure
409(2)
Effects of Renal Failure on the Body Fluids---Uremia
411(1)
Hypertension and Kidney Disease
412(1)
Specific Tubular Disorders
413(1)
Treatment of Renal Failure by Dialysis with an Artificial Kidney
414(5)
UNIT VI Blood Cells, Immunity, and Blood Clotting
Red Blood Cells, Anemia, and Polycythemia
419(10)
Red Blood Cells (Erythrocytes)
419(7)
Production of Red Blood Cells
420(4)
Formation of Hemoglobin
424(1)
Iron Metabolism
425(1)
Life Span and Destruction of Red Blood Cells
426(1)
Anemias
426(1)
Effects of Anemia on Function of the Circulatory System
427(1)
Polycythemia
427(2)
Effect of Polycythemia on Function of the Circulatory System
428(1)
Resistance of the Body to Infection: I. Leukocytes, Granulocytes, the Monocyte-Macrophage System, and Inflammation
429(10)
Leukocytes (White Blood Cells)
429(2)
General Characteristics of Leukocytes
429(1)
Genesis of the White Blood Cells
430(1)
Life Span of the White Blood Cells
431(1)
Neutrophils and Macrophages Defend Against Infections
431(1)
Phagocytosis
431(1)
Monocyte-Macrophage Cell System (Reticuloendothelial System)
432(2)
Inflammation: Role of Neutrophils and Macrophages
434(2)
Inflammation
434(1)
Macrophage and Neutrophil Responses During Inflammation
434(2)
Eosinophils
436(1)
Basophils
436(1)
Leukopenia
436(1)
The Leukemias
437(2)
Effects of Leukemia on the Body
437(2)
Resistance of the Body to Infection: II. Immunity and Allergy
439(12)
Innate Immunity
439(1)
Acquired (Adaptive) Immunity
439(10)
Basic Types of Acquired Immunity
440(1)
Both Types of Acquired Immunity Are Initiated by Antigens
440(1)
Lymphocytes Are Responsible for Acquired Immunity
440(1)
Preprocessing of the T and B Lymphocytes
440(2)
T Lymphocytes and B-Lymphocyte Antibodies React Highly Specifically Against Specific Antigens---Role of Lymphocyte Clones
442(1)
Origin of the Many Clones of Lymphocytes
442(1)
Specific Attributes of the B-Lymphocyte System---Humoral Immunity and the Antibodies
443(3)
Special Attributes of the T-Lymphocyte System---Activated T Cells and Cell-Mediated Immunity
446(1)
Several Types of T Cells and Their Different Functions
446(2)
Tolerance of the Acquired Immunity System to One's Own Tissues---Role of Preprocessing in the Thymus and Bone Marrow
448(1)
Immunization by Injection of Antigens
448(1)
Passive Immunity
449(1)
Allergy and Hypersensitivity
449(2)
Allergy Caused by Activated T Cells: Delayed-Reaction Allergy
449(1)
Allergies in the ``Allergic'' Person, Who Has Excess IgE Antibodies
449(2)
Blood Types; Transfusion; Tissue and Organ Transplantation
451(6)
Antigenicity Causes Immune Reactions of Blood
451(1)
O-A-B Blood Types
451(2)
A and B Antigens---Agglutinogens
451(1)
Agglutinins
452(1)
Agglutination Process In Transfusion Reactions
452(1)
Blood Typing
453(1)
Rh Blood Types
453(2)
Rh Immune Response
453(1)
Transfusion Reactions Resulting from Mismatched Blood Types
454(1)
Transplantation of Tissues and Organs
455(2)
Attempts to Overcome Immune Reactions in Transplanted Tissue
455(2)
Hemostasis and Blood Coagulation
457(14)
Events in Hemostasis
457(2)
Vascular Constriction
457(1)
Formation of the Platelet Plug
457(1)
Blood Coagulation in the Ruptured Vessel
458(1)
Fibrous Organization or Dissolution of the Blood Clot
458(1)
Mechanism of Blood Coagulation
459(5)
Conversion of Prothrombin to Thrombin
459(1)
Conversion of Fibrinogen to Fibrin---Formation of the Clot
460(1)
Vicious Circle of Clot Formation
460(1)
Initiation of Coagulation: Formation of Prothrombin Activator
461(2)
Prevention of Blood Clotting in the Normal Vascular System---Intravascular Anticoagulants
463(1)
Lysis of Blood Clots---Plasmin
464(1)
Conditions That Cause Excessive Bleeding in Human Beings
464(1)
Decreased Prothrombin, Factor VII, Factor IX, and Factor X Caused by Vitamin K Deficiency
464(1)
Hemophilia
465(1)
Thrombocytopenia
465(1)
Thromboembolic Conditions in the Human Being
465(1)
Femoral Venous Thrombosis and Massive Pulmonary Embolism
466(1)
Disseminated Intravascular Coagulation
466(1)
Anticoagulants for Clinical Use
466(1)
Heparin as an Intravenous Anticoagulant
466(1)
Coumarins as Anticoagulants
466(1)
Prevention of Blood Coagulation Outside the Body
466(1)
Blood Coagulation Tests
467(4)
Bleeding Time
467(1)
Clotting Time
467(1)
Prothrombin Time
467(4)
UNIT VII Respiration
Pulmonary Ventilation
471(12)
Mechanics of Pulmonary Ventilation
471(4)
Muscles That Cause Lung Expansion and Contraction
471(1)
Movement of Air In and Out of the Lungs and the Pressures That Cause the Movement
472(2)
Effect of the Thoracic Cage on Lung Expansibility
474(1)
Pulmonary Volumes and Capacities
475(2)
Recording Changes in Pulmonary Volume---Spirometry
475(1)
Abbreviations and Symbols Used in Pulmonary Function Tests
476(1)
Determination of Functional Residual Capacity, Residual Volume, and Total Lung Capacity---Helium Dilution Method
476(1)
Minute Respiratory Volume Equals Respiratory Rate Times Tidal Volume
477(1)
Alveolar Ventilation
477(1)
``Dead Space'' and Its Effect on Alveolar Ventilation
477(1)
Rate of Alveolar Ventilation
478(1)
Functions of the Respiratory Passageways
478(5)
Trachea, Bronchi, and Bronchioles
478(2)
Normal Respiratory Functions of the Nose
480(3)
Pulmonary Circulation, Pulmonary Edema, Pleural Fluid
483(8)
Physiologic Anatomy of the Pulmonary Circulatory System
483(1)
Pressures in the Pulmonary System
483(1)
Blood Volume of the Lungs
484(1)
Blood Flow Through the Lungs and Its Distribution
485(1)
Effect of Hydrostatic Pressure Gradients in the Lungs on Regional Pulmonary Blood Flow
485(2)
Zones 1, 2, and 3 of Pulmonary Blood Flow
485(1)
Effect of Increased Cardiac Output on Pulmonary Blood Flow and Pulmonary Arterial Pressure During Heavy Exercise
486(1)
Function of the Pulmonary Circulation When the Left Atrial Pressure Rises as a Result of Left-Sided Heart Failure
487(1)
Pulmonary Capillary Dynamics
487(2)
Capillary Exchange of Fluid in the Lungs, and Pulmonary Interstitial Fluid Dynamics
487(1)
Pulmonary Edema
488(1)
Fluid in the Pleural Cavity
489(2)
Physical Principles of Gas Exchange; Diffusion of Oxygen and Carbon Dioxide Through the Respiratory Membrane
491(11)
Physics of Gas Diffusion and Gas Partial Pressures
491(2)
Molecular Basis of Gas Diffusion
491(1)
Gas Pressures in a Mixture of Gases---``Partial Pressures'' of Individual Gases
491(1)
Pressures of Gases Dissolved in Water and Tissues
492(1)
Vapor Pressure of Water
492(1)
Diffusion of Gases Through Fluids---Pressure Difference Causes Net Diffusion
493(1)
Diffusion of Gases Through Tissues
493(1)
Composition of Alveolar Air---Its Relation to Atmospheric Air
493(3)
Rate at Which Alveolar Air Is Renewed by Atmospheric Air
494(1)
Oxygen Concentration and Partial Pressure in the Alveoli
494(1)
CO2 Concentration and Partial Pressure in the Alveoli
495(1)
Expired Air
495(1)
Diffusion of Gases Through the Respiratory Membrane
496(3)
Factors That Affect the Rate of Gas Diffusion Through the Respiratory Membrane
498(1)
Diffusing Capacity of the Respiratory Membrane
498(1)
Effect of the Ventilation-Perfusion Ratio on Alveolar Gas Concentration
499(3)
PO2-PCO2, VA/Q Diagram
500(1)
Concept of the ``Physiological Shunt'' (When VA/Q Is Greater Than Normal)
500(1)
Abnormalities of Ventilation-Perfusion Ratio
501(1)
Transport of Oxygen and Carbon Dioxide in Blood and Tissue Fluids
502(12)
Transport of Oxygen from the Lungs to the Body Tissues
502(8)
Diffusion of Oxygen from the Alveoli to the Pulmonary Capillary Blood
502(1)
Transport of Oxygen in the Arterial Blood
503(1)
Diffusion of Oxygen from the Peripheral Capillaries into the Tissue Fluid
503(1)
Diffusion of Oxygen from the Peripheral Capillaries to the Tissue Cells
504(1)
Diffusion of Carbon Dioxide from the Peripheral Tissue Cells into the Capillaries and from the Pulmonary Capillaries into the Alveoli
504(1)
Role of Hemoglobin in Oxygen Transport
505(1)
Reversible Combination of Oxygen with Hemoglobin
505(2)
Effect of Hemoglobin to ``Buffer'' the Tissue PO2
507(1)
Factors That Shift the Oxygen-Hemoglobin Dissociation Curve---Their Importance for Oxygen Transport
507(1)
Metabolic Use of Oxygen by the Cells
508(1)
Transport of Oxygen in the Dissolved State
509(1)
Combination of Hemoglobin with Carbon Monoxide---Displacement of Oxygen
509(1)
Transport of Carbon Dioxide in the Blood
510(2)
Chemical Forms In Which Carbon Dioxide Is Transported
510(1)
Carbon Dioxide Dissociation Curve
511(1)
When Oxygen Binds with Hemoglobin, Carbon Dioxide Is Released (the Haldane Effect) to Increase CO2 Transport
511(1)
Change in Blood Acidity During Carbon Dioxide Transport
512(1)
Respiratory Exchange Ratio
512(2)
Regulation of Respiration
514(10)
Respiratory Center
514(2)
Dorsal Respiratory Group of Neurons---Its Control of Inspiration and of Respiratory Rhythm
514(1)
A Pneumotaxic Center Limits the Duration of Inspiration and Increases the Respiratory Rate
514(1)
Ventral Respiratory Group of Neurons---Functions in Both Inspiration and Expiration
515(1)
Lung Inflation Signals Limit Inspiration---The Hering-Breuer Inflation Reflex
515(1)
Control of Overall Respiratory Center Activity
516(1)
Chemical Control of Respiration
516(2)
Direct Chemical Control of Respiratory Center Activity by Carbon Dioxide and Hydrogen Ions
516(2)
Peripheral Chemoreceptor System for Control of Respiratory Activity---Role of Oxygen in Respiratory Control
518(2)
Effect of Low Arterial PO2 to Stimulate Alveolar Ventilation When Arterial Carbon Dioxide and Hydrogen Ion Concentrations Remain Normal
519(1)
Chronic Breathing of Low Oxygen Stimulates Respiration Even More---The Phenomenon of ``Acclimatization''
519(1)
Composite Effects of PCO2, pH, and PO2 on Alveolar Ventilation
519(1)
Regulation of Respiration During Exercise
520(1)
Other Factors That Affect Respiration
521(3)
Sleep Apnea
522(2)
Respiratory Insufficiency---Pathophysiology, Diagnosis, Oxygen Therapy
524(13)
Useful Methods for Studying Respiratory Abnormalities
524(1)
Study of Blood Gases and Blood pH
524(1)
Measurement of Maximum Expiratory Flow
525(1)
Forced Expiratory Vital Capacity and Forced Expiratory Volume
526(1)
Physiologic Peculiarities of Specific Pulmonary Abnormalities
526(4)
Chronic Pulmonary Emphysema
526(1)
Pneumonia
527(1)
Atelectasis
528(1)
Asthma
529(1)
Tuberculosis
530(1)
Hypoxia and Oxygen Therapy
530(1)
Oxygen Therapy in Different Types of Hypoxia
530(1)
Cyanosis
531(1)
Hypercapnia
531(1)
Dyspnea
532(1)
Artificial Respiration
532(5)
UNIT VIII Aviation, Space, and Deep-Sea Diving Physiology
Aviation, High-Altitude, and Space Physiology
537(8)
Effects of Low Oxygen Pressure on the Body
537(4)
Alveolar PO2 at Different Elevations
537(1)
Effect of Breathing Pure Oxygen on Alveolar PO2 at Different Altitudes
538(1)
Acute Effects of Hypoxia
538(1)
Acclimatization to Low PO2
539(1)
Natural Acclimatization of Native Human Beings Living at High Altitudes
540(1)
Reduced Work Capacity at High Altitudes and Positive Effect of Acclimatization
540(1)
Acute Mountain Sickness and High-Altitude Pulmonary Edema
540(1)
Chronic Mountain Sickness
541(1)
Effects of Acceleratory Forces on the Body in Aviation and Space Physiology
541(2)
Centrifugal Acceleratory Forces
541(1)
Effects of Linear Acceleratory Forces on the Body
542(1)
``Artificial Climate'' in the Sealed Spacecraft
543(1)
Weightlessness in Space
543(2)
Physiology of Deep-Sea Diving and Other Hyperbaric Conditions
545(10)
Effect of High Partial Pressures of Individual Gases on the Body
545(4)
Nitrogen Narcosis at High Nitrogen Pressures
545(1)
Oxygen Toxicity at High Pressures
546(1)
Carbon Dioxide Toxicity at Great Depths in the Sea
547(1)
Decompression of the Diver After Excess Exposure to High Pressure
547(2)
Scuba (Self-Contained Underwater Breathing Apparatus) Diving
549(1)
Special Physiologic Problems in Submarines
550(1)
Hyperbaric Oxygen Therapy
550(5)
UNIT IX The Nervous System: A. General Principles and Sensory Physiology
Organization of the Nervous System, Basic Functions of Synapses, ``Transmitter Substances''
555(17)
General Design of the Nervous System
555(2)
Central Nervous System Neuron: The Basic Functional Unit
555(1)
Sensory Part of the Nervous System---Sensory Receptors
555(1)
Motor Part of the Nervous System---Effectors
556(1)
Processing of Information---``Integrative'' Function of the Nervous System
556(1)
Storage of Information---Memory
557(1)
Major Levels of Central Nervous System Function
557(1)
Spinal Cord Level
557(1)
Lower Brain or Subcortical Level
558(1)
Higher Brain or Cortical Level
558(1)
Comparison of the Nervous System with a Computer
558(1)
Central Nervous System Synapses
559(11)
Types of Synapses---Chemical and Electrical
559(1)
Physiologic Anatomy of the Synapse
559(3)
Chemical Substances That Function as Synaptic Transmitters
562(2)
Electrical Events During Neuronal Excitation
564(2)
Electrical Events During Neuronal Inhibition
566(2)
Special Functions of Dendrites for Exciting Neurons
568(1)
Relation of State of Excitation of the Neuron to Rate of Firing
569(1)
Some Special Characteristics of Synaptic Transmission
570(2)
Sensory Receptors, Neuronal Circuits for Processing Information
572(13)
Types of Sensory Receptors and the Sensory Stimuli They Detect
572(1)
Differential Sensitivity of Receptors
572(1)
Transduction of Sensory Stimuli into Nerve Impulses
573(3)
Local Electrical Currents at Nerve Endings---Receptor Potentials
573(2)
Adaptation of Receptors
575(1)
Nerve Fibers That Transmit Different Types of Signals, and Their Physiologic Classification
576(1)
Transmission of Signals of Different Intensity in Nerve Tracts---Spatial and Temporal Summation
577(1)
Transmission and Processing of Signals in Neuronal Pools
578(5)
Relaying of Signals Through Neuronal Pools
579(2)
Prolongation of a Signal by a Neuronal Pool---``Afterdischarge''
581(2)
Instability and Stability of Neuronal Circuits
583(2)
Inhibitory Circuits as a Mechanism for Stabilizing Nervous System Function
583(1)
Synaptic Fatigue as a Means for Stabilizing the Nervous System
583(2)
Somatic Sensations: I. General Organization, the Tactile and Position Senses
585(13)
Classification of Somatic Senses
585(1)
Detection and Transmission of Tactile Sensations
585(2)
Detection of Vibration
587(1)
Tickle and Itch
587(1)
Sensory Pathways for Transmitting Somatic Signals into the Central Nervous System
587(1)
Dorsal Column--Medial Lemniscal System
588(1)
Anterolateral System
588(1)
Transmission in the Dorsal Column---Medial Lemniscal System
588(7)
Anatomy of the Dorsal Column---Medial Lemniscal System
588(1)
Somatosensory Cortex
589(3)
Somatosensory Association Areas
592(1)
Overall Characteristics of Signal Transmission and Analysis in the Dorsal Column--Medial Lemniscal System
592(2)
Position Senses
594
Interpretation of Sensory Stimulus Intensity
593(1)
Judgment of Stimulus Intensity
594(1)
Position Senses
594(1)
Transmission of Less Critical Sensory Signals in the Anterolateral Pathway
595(1)
Anatomy of the Anterolateral Pathway
595(1)
Some Special Aspects of Somatosensory Function
596(2)
Function of the Thalamus in Somatic Sensation
596(1)
Cortical Control of Sensory Sensitivity---``Corticofugal'' Signals
597(1)
Segmental Fields of Sensation---The Dermatomes
597(1)
Somatic Sensations: II. Pain, Headache, and Thermal Sensations
598(15)
Types of Pain and Their Qualities---Fast Pain and Slow Pain
598(1)
Pain Receptors and Their Stimulation
598(2)
Rate of Tissue Damage as a Stimulus for Pain
599(1)
Dual Pathways for Transmission of Pain Signals into the Central Nervous System
600(2)
Dual Pain Pathways in the Cord and Brain Stem---The Neospinothalamic Tract and the Paleospinothalamic Tract
600(2)
Pain Suppression (``Analgesia'') System in the Brain and Spinal Cord
602(1)
Brain's Opiate System---Endorphins and Enkephalins
602(1)
Inhibition of Pain Transmission by Simultaneous Tactile Sensory Signals
603(1)
Treatment of Pain by Electrical Stimulation
603(1)
Referred Pain
603(1)
Visceral Pain
603(2)
Causes of True Visceral Pain
604(1)
``Parietal Pain'' Caused by Visceral Disease
604(1)
Localization of Visceral Pain---``Visceral'' and the ``Parietal'' Pain Transmission Pathways
604(1)
Some Clinical Abnormalities of Pain and Other Somatic Sensations
605(1)
Hyperalgesia
605(1)
Herpes Zoster (Shingles)
605(1)
Tic Douloureux
605(1)
Brown-Sequard Syndrome
606(1)
Headache
606(1)
Headache of Intracranial Origin
606(1)
Thermal Sensations
607(6)
Thermal Receptors and Their Excitation
607(2)
Transmission of Thermal Signals in the Nervous System
609(4)
UNIT X The Nervous System: B. The Special Senses
The Eye: I. Optics of Vision
613(13)
Physical Principles of Optics
613(4)
Refraction of Light
613(1)
Application of Refractive Principles to Lenses
613(2)
Focal Length of a Lens
615(1)
Formation of an Image by a Convex Lens
616(1)
Measurement of the Refractive Power of a Lens---``Diopter''
616(1)
Optics of the Eye
617(5)
The Eye as a Camera
617(1)
Mechanism of ``Accommodation''
617(1)
Pupillary Diameter
618(1)
Errors of Refraction
619(2)
Visual Acuity
621(1)
Determination of Distance of an Object from the Eye---``Depth Perception''
621(1)
Ophthalmoscope
622(1)
Fluid System of the Eye---Intraocular Fluid
623(3)
Formation of Aqueous Humor by the Ciliary Body
623(1)
Outflow of Aqueous Humor from the Eye
623(1)
Intraocular Pressure
624(2)
The Eye: II. Receptor and Neural Function of the Retina
626(14)
Anatomy and Function of the Structural Elements of the Retina
626(2)
Photochemistry of Vision
628(4)
Rhodopsin-Retinal Visual Cycle, and Excitation of the Rods
629(2)
Automatic Regulation of Retinal Sensitivity---Light and Dark Adaptation
631(1)
Color Vision
632(1)
Tricolor Mechanism of Color Detection
632(1)
Color Blindness
633(1)
Neural Function of the Retina
633(7)
Neural Circuitry of the Retina
633(3)
Ganglion Cells and Optic Nerve Fibers
636(1)
Excitation of the Ganglion Cells
637(3)
The Eye: III. Central Neurophysiology of Vision
640(11)
Visual Pathways
640(1)
Function of the Dorsal Lateral Geniculate Nucleus of the Thalamus
640(1)
Organization and Function of the Visual Cortex
641(2)
Layered Structure of the Primary Visual Cortex
642(1)
Two Major Pathways for Analysis of Visual Information---(1) The Fast ``Position'' and ``Motion'' Pathway; (2) The Accurate Color Pathway
643(1)
Neuronal Patterns of Stimulation During Analysis of the Visual Image
643(1)
Detection of Color
644(1)
Effect of Removing the Primary Visual Cortex
644(1)
Fields of Vision; Perimetry
644(1)
Eye Movements and Their Control
645(3)
Fixation Movements of the Eyes
645(2)
``Fusion'' of the Visual Images from the Two Eyes
647(1)
Autonomic Control of Accommodation and Pupillary Aperture
648(3)
Control of Accommodation (Focusing the Eyes)
649(1)
Control of Pupillary Diameter
649(2)
The Sense of Hearing
651(12)
Tympanic Membrane and the Ossicular System
651(1)
Conduction of Sound from the Tympanic Membrane to the Cochlea
651(1)
Transmission of Sound Through Bone
652(1)
Cochlea
652(5)
Functional Anatomy of the Cochlea
652(2)
Transmission of Sound Waves in the Cochlea---``Traveling Wave''
654(1)
Function of the Organ of Corti
655(1)
Determination of Sound Frequency---The ``Place'' Principle
656(1)
Determination of Loudness
656(1)
Central Auditory Mechanisms
657(3)
Auditory Nervous Pathways
657(1)
Function of the Cerebral Cortex in Hearing
658(2)
Determination of the Direction from Which Sound Comes
660(1)
Centrifugal Signals from the Central Nervous System to Lower Auditory Centers
660(1)
Hearing Abnormalities
660(3)
Types of Deafness
660(3)
The Chemical Senses---Taste and Smell
663(10)
Sense of Taste
663(4)
Primary Sensations of Taste
663(1)
Taste Bud and Its Function
664(1)
Transmission of Taste Signals into the Central Nervous System
665(1)
Taste Preference and Control of the Diet
666(1)
Sense of Smell
667(6)
Olfactory Membrane
667(1)
Stimulation of the Olfactory Cells
667(1)
Transmission of Smell Signals into the Central Nervous System
668(5)
UNIT XI The Nervous System: C. Motor and Integrative Neurophysiology
Motor Functions of the Spinal Cord; the Cord Reflexes
673(12)
Organization of the Spinal Cord for Motor Functions
673(2)
Muscle Sensory Receptors---Muscle Spindles and Golgi Tendon Organs---And Their Roles in Muscle Control
675(5)
Receptor Function of the Muscle Spindle
675(1)
Muscle Stretch Reflex
676(2)
Role of the Muscle Spindle in Voluntary Motor Activity
678(1)
Clinical Applications of the Stretch Reflex
678(1)
Golgi Tendon Reflex
679(1)
Function of the Muscle Spindles and Golgi Tendon Organs in Conjunction with Motor Control from Higher Levels of the Brain
680(1)
Flexor Reflex and the Withdrawal Reflexes
680(1)
Crossed Extensor Reflex
681(1)
Reciprocal Inhibition and Reciprocal Innervation
681(1)
Reflexes of Posture and Locomotion
682(1)
Postural and Locomotive Reflexes of the Cord
682(1)
Scratch Reflex
683(1)
Spinal Cord Reflexes That Cause Muscle Spasm
683(1)
Autonomic Reflexes in the Spinal Cord
683(1)
Spinal Cord Transection and Spinal Shock
684(1)
Cortical and Brain Stem Control of Motor Function
685(13)
Motor Cortex and Corticospinal Tract
685(6)
Primary Motor Cortex
685(1)
Premotor Area
686(1)
Supplementary Motor Area
686(1)
Some Specialized Areas of Motor Control Found in the Human Motor Cortex
686(1)
Transmission of Signals from the Motor Cortex to the Muscles
687(1)
Incoming Fiber Pathways to the Motor Cortex
688(1)
Red Nucleus Serves as an Alternative Pathway for Transmitting Cortical Signals to the Spinal Cord
688(1)
``Extrapyramidal'' System
689(1)
Excitation of the Spinal Cord Motor Control Areas by the Primary Motor Cortex and Red Nucleus
689(2)
Role of the Brain Stem in Controlling Motor Function
691(1)
Support of the Body Against Gravity---Roles of the Reticular and Vestibular Nuclei
691(1)
Vestibular Sensations and Maintenance of Equilibrium
692(5)
Vestibular Apparatus
692(2)
Function of the Utricle and Saccule in the Maintenance of Static Equilibrium
694(1)
Detection of Head Rotation by the Semicircular Ducts
695(1)
Vestibular Mechanisms for Stabilizing the Eyes
696(1)
Other Factors Concerned with Equilibrium
696(1)
Functions of Brain Stem Nuclei in Controlling Subconscious, Stereotyped Movements
697(1)
Contributions of the Cerebellum and Basal Ganglia to Overall Motor Control
698(16)
Cerebellum and Its Motor Functions
698(9)
Anatomical Functional Areas of the Cerebellum
699(1)
Neuronal Circuit of the Cerebellum
700(3)
Function of the Cerebellum in Overall Motor Control
703(3)
Clinical Abnormalities of the Cerebellum
706(1)
Basal Ganglia---Their Motor Functions
707(5)
Function of the Basal Ganglia In Executing Patterns of Motor Activity---The Putamen Circuit
708(1)
Role of the Basal Ganglia for Cognitive Control of Sequences of Motor Patterns---The Caudate Circuit
709(1)
Function of the Basal Ganglia to Change the Timing and to Scale the Intensity of Movements
709(1)
Functions of Specific Neurotransmitter Substances in the Basal Ganglial System
710(2)
Integration of the Many Parts of the Total Motor Control System
712(2)
Spinal Level
712(1)
Hindbrain Level
712(1)
Motor Cortex Level
712(1)
What Drives Us to Action?
713(1)
Cerebral Cortex, Intellectual Functions of the Brain, Learning and Memory
714(14)
Physiologic Anatomy of the Cerebral Cortex
714(1)
Functions of Specific Cortical Areas
715(5)
Association Areas
716(2)
Comprehensive Interpretative Function of the Posterior Superior Temporal Lobe---``Wernicke's Area'' (a General Interpretative Area)
718(1)
Functions of the Parieto-occipitotemporal Cortex in the Nondominant Hemisphere
719(1)
Higher Intellectual Functions of the Prefrontal Association Areas
719(1)
Function of the Brain in Communication---Language Input and Language Output
720(2)
Function of the Corpus Callosum and Anterior Commissure to Transfer Thoughts, Memories, Training, and Other Information Between the Two Cerebral Hemispheres
722(1)
Thoughts, Consciousness, and Memory
723(5)
Memory---Roles of Synaptic Facilitation and Synaptic Inhibition
723(1)
Short-Term Memory
724(1)
Intermediate Long-Term Memory
724(1)
Long-Term Memory
725(1)
Consolidation of Memory
725(3)
Behavioral and Motivational Mechanisms of the Brain---The Limbic System and the Hypothalamus
728(11)
Activating-Driving Systems of the Brain
728(3)
Control of Cerebral Activity by Continuous Excitatory Signals from the Brain Stem
728(2)
Neurohormonal Control of Brain Activity
730(1)
Limbic System
731(1)
Functional Anatomy of the Limbic System; Key Position of the Hypothalamus
731(1)
Hypothalamus, a Major Control Headquarters for the Limbic System
732(4)
Vegetative and Endocrine Control Functions of the Hypothalamus
733(1)
Behavioral Functions of the Hypothalamus and Associated Limbic Structures
734(1)
``Reward'' and ``Punishment'' Function of the Limbic System
735(1)
Importance of Reward or Punishment in Behavior
736(1)
Specific Functions of Other Parts of the Limbic System
736(3)
Functions of the Hippocampus
736(1)
Functions of the Amygdala
737(1)
Function of the Limbic Cortex
738(1)
States of Brain Activity---Sleep, Brain Waves, Epilepsy, Psychoses
739(9)
Sleep
739(2)
Slow-Wave Sleep
739(1)
REM Sleep (Paradoxical Sleep, Desynchronized Sleep)
740(1)
Basic Theories of Sleep
740(1)
Physiologic Effects of Sleep
741(1)
Brain Waves
741(2)
Origin of Brain Waves
742(1)
Effect of Varying Levels of Cerebral Activity on the Frequency of the EEG
743(1)
Changes in the EEG at Different Stages of Wakefulness and Sleep
743(1)
Epilepsy
743(2)
Grand Mal Epilepsy
743(1)
Petit Mal Epilepsy
744(1)
Focal Epilepsy
744(1)
Psychotic Behavior and Dementia---Roles of Specific Neurotransmitter Systems
745(3)
Depression and Manic-Depressive Psychoses---Decreased Activity of the Norepinephrine and Serotonin Neurotransmitter Systems
745(1)
Schizophrenia---Possible Exaggerated Function of Part of the Dopamine System
745(1)
Alzheimer's Disease---Amyloid Plaques and Depressed Memory
746(2)
The Autonomic Nervous System and the Adrenal Medulla
748(13)
General Organization of the Autonomic Nervous System
748(2)
Physiologic Anatomy of the Sympathetic Nervous System
748(1)
Preganglionic and Postganglionic Sympathetic Neurons
748(2)
Physiologic Anatomy of the Parasympathetic Nervous System
750(1)
Basic Characteristics of Sympathetic and Parasympathetic Function
750(7)
Cholinergic and Adrenergic Fibers---Secretion of Acetylcholine or Norepinephrine
750(2)
Receptors on the Effector Organs
752(1)
Excitatory and Inhibitory Actions of Sympathetic and Parasympathetic Stimulation
753(1)
Effects of Sympathetic and Parasympathetic Stimulation on Specific Organs
753(2)
Function of the Adrenal Medullae
755(1)
Relation of Stimulus Rate to Degree of Sympathetic and Parasympathetic Effect
756(1)
Sympathetic and Parasympathetic ``Tone''
756(1)
Denervation Supersensitivity of Sympathetic and Parasympathetic Organs after Denervation
756(1)
Autonomic Reflexes
757(1)
Stimulation of Discrete Organs in Some Instances and Mass Stimulation in Other Instances by the Sympathetic and Parasympathetic Systems
757(2)
``Alarm'' or ``Stress'' Response of the Sympathetic Nervous System
758(1)
Medullary, Pontine, and Mesencephalic Control of the Autonomic Nervous System
758(1)
Pharmacology of the Autonomic Nervous System
759(2)
Drugs That Act on Adrenergic Effector Organs---Sympathomimetic Drugs
759(1)
Drugs That Act on Cholinergic Effector Organs
759(1)
Drugs That Stimulate or Block Sympathetic and Parasympathetic Postganglionic Neurons
759(2)
Cerebral Blood Flow, Cerebrospinal Fluid, and Brain Metabolism
761(10)
Cerebral Blood Flow
761(2)
Normal Rate of Cerebral Blood Flow
761(1)
Regulation of Cerebral Blood Flow
761(2)
Cerebral Microcirculation
763(1)
Cerebral Stroke Occurs When Cerebral Blood Vessels are Blocked
763(1)
Cerebrospinal Fluid System
763(4)
Cushioning Function of the Cerebrospinal Fluid
763(1)
Formation, Flow, and Absorption of Cerebrospinal Fluid
764(1)
Cerebrospinal Fluid Pressure
765(1)
Obstruction to Flow of Cerebrospinal Fluid Can Cause Hydrocephalus
766(1)
Blood--Cerebrospinal Fluid and Blood-Brain Barriers
766(1)
Brain Edema
766(1)
Brain Metabolism
767(4)
UNIT XII Gastrointestinal Physiology
General Principles of Gastrointestinal Function---Motility, Nervous Control, and Blood Circulation
771(10)
General Principles of Gastrointestinal Motility
771(2)
Physiological Anatomy of the Gastrointestinal Wall
771(2)
Neural Control of Gastrointestinal Function---Enteric Nervous System
773(3)
Differences Between the Myenteric and Submucosal Plexuses
774(1)
Types of Neurotransmitters Secreted by Enteric Neurons
775(1)
Hormonal Control of Gastrointestinal Motility
776(1)
Functional Types of Movements in the Gastrointestinal Tract
776(1)
Propulsive Movements---Peristalsis
776(1)
Mixing Movements
777(1)
Gastrointestinal Blood Flow---``Splanchnic Circulation''
777(4)
Anatomy of the Gastrointestinal Blood Supply
778(1)
Effect of Gut Activity and Metabolic Factors on Gastrointestinal Blood Flow
778(1)
Nervous Control of Gastrointestinal Blood Flow
779(2)
Propulsion and Mixing of Food in the Alimentary Tract
781(10)
Ingestion of Food
781(3)
Mastication (Chewing)
781(1)
Swallowing (Deglutition)
782(2)
Motor Functions of the Stomach
784(2)
Storage Function of the Stomach
784(1)
Mixing and Propulsion Of Food in the Stomach---The Basic Electrical Rhythm of the Stomach Wall
784(1)
Stomach Emptying
785(1)
Regulation of Stomach Emptying
785(1)
Movements of the Small Intestine
786(2)
Mixing Contractions (Segmentation Contractions)
786(1)
Propulsive Movements
787(1)
Function of the Ileocecal Valve
788(1)
Movements of the Colon
788(2)
Defecation
789(1)
Other Autonomic Reflexes That Affect Bowel Activity
790(1)
Secretory Functions of the Alimentary Tract
791(17)
General Principles of Alimentary Tract Secretion
791(2)
Anatomical Types of Glands
791(1)
Basic Mechanisms of Stimulation of the Alimentary Tract Glands
791(1)
Basic Mechanism of Secretion by Glandular Cells
791(2)
Lubricating and Protective Properties of Mucus, and Importance of Mucus in the Gastrointestinal Tract
793(1)
Secretion of Saliva
793(2)
Nervous Regulation of Salivary Secretion
794(1)
Esophageal Secretion
795
Gastric Secretion
794(5)
Characteristics of the Gastric Secretions
794(3)
Pyloric Glands---Secretion of Mucus and Gastrin
797(1)
Surface Mucous Cells
797(1)
Stimulation of Gastric Acid Secretion
797(1)
Regulation of Pepsinogen Secretion
798(1)
Inhibition of Gastric Secretion by Other Post-Stomach Intestinal Factors
798(1)
Chemical Composition of Gastrin And Other Gastrointestinal Hormones
799(1)
Pancreatic Secretion
799(3)
Pancreatic Digestive Enzymes
799(1)
Secretion of Bicarbonate Ions
800(1)
Regulation of Pancreatic Secretion
800(2)
Secretion of Bile by the Liver; Functions of the Biliary Tree
802(3)
Physiologic Anatomy of Biliary Secretion
802(2)
Function of Bile Salts in Fat Digestion and Absorption
804(1)
Liver Secretion of Cholesterol and Gallstone Formation
804(1)
Secretions of the Small Intestine
805(1)
Secretion of Mucus by Brunner's Glands in the Duodenum
805(1)
Secretion of Intestinal Digestive Juices by the Crypts of Lieberkuhn
805(1)
Regulation of Small Intestine Secretion---Local Stimuli
806(1)
Secretions of the Large Intestine
806(2)
Digestion and Absorption in the Gastrointestinal Tract
808(11)
Digestion of the Various Foods by Hydrolysis
808(4)
Digestion of Carbohydrates
809(1)
Digestion of Proteins
810(1)
Digestion of Fats
811(1)
Basic Principles of Gastrointestinal Absorption
812(1)
Anatomical Basis of Absorption
812(1)
Absorption in the Small Intestine
813(4)
Absorption of Water
814(1)
Absorption of Ions
814(1)
Absorption of Nutrients
815(2)
Absorption in the Large Intestine: Formation of Feces
817(2)
Physiology of Gastrointestinal Disorders
819(10)
Disorders of Swallowing and of the Esophagus
819(1)
Disorders of the Stomach
819(2)
Peptic Ulcer
820(1)
Specific Causes of Peptic Ulcer in the Human Being
821(1)
Disorders of the Small Intestine
821(1)
Abnormal Digestion of Food in the Small Intestine---Pancreatic Failure
821(1)
Malabsorption by the Small Intestine Mucosa---Sprue
822(1)
Disorders of the Large Intestine
822(1)
Constipation
822(1)
Diarrhea
822(1)
Paralysis of Defecation in Spinal Cord Injuries
823(1)
General Disorders of the Gastrointestinal Tract
823(6)
Vomiting
823(1)
Nausea
824(1)
Gastrointestinal Obstruction
824(5)
UNIT XIII Metabolism and Temperature Regulation
Metabolism of Carbohydrates, and Formation of Adenosine Triphosphate
829(11)
Release of Energy from Foods, and the Concept of ``Free Energy''
829(1)
Role of Adenosine Triphosphate in Metabolism
829(1)
Central Role of Glucose in Carbohydrate Metabolism
830(1)
Transport of Glucose Through the Cell Membrane
831(1)
Insulin Increases Facilitated Diffusion of Glucose
831(1)
Phosphorylation of Glucose
831(1)
Glycogen Is Stored in Liver and Muscle
831(1)
Glycogenesis---The Process of Glycogen Formation
832(1)
Removal of Stored Glycogen---Glycogenolysis
832(1)
Release of Energy from the Glucose Molecule by the Glycolytic Pathway
832(5)
Summary of ATP Formation During the Breakdown of Glucose
836(1)
Control of Energy Release from Stored Glycogen When the Body Needs Additional Energy
836(1)
Anaerobic Release of Energy---``Anaerobic Glycolysis''
836(1)
Release of Energy from Glucose by the Pentose Phosphate Pathway
837(1)
Glucose Conversion to Glycogen or Fat
838(1)
Formation of Carbohydrates from Proteins and Fats---``Gluconeogenesis''
838(1)
Blood Glucose
839(1)
Lipid Metabolism
840(12)
Transport of Lipids in the Body Fluids
840(2)
Transport of Triglycerides and Other Lipids from the Gastrointestinal Tract by Lymph---The Chylomicrons
840(1)
Removal of the Chylomicrons from the Blood
841(1)
``Free Fatty Acids'' Are Transported in the Blood in Combination with Albumin
841(1)
Lipoproteins---Their Special Function in Transporting Cholesterol and Phospholipids
841(1)
Fat Deposits
842(1)
Adipose Tissue
842(1)
Liver Lipids
842(1)
Use of Triglycerides for Energy: Formation of Adenosine Triphosphate
842(4)
Formation of Acetoacetic Acid in the Liver and Its Transport in the Blood
844(1)
Synthesis of Triglycerides from Carbohydrates
844(1)
Synthesis of Triglycerides from Proteins
845(1)
Regulation of Energy Release from Triglycerides
846(1)
Obesity
846(1)
Phospholipids and Cholesterol
846(2)
Phospholipids
846(1)
Cholesterol
847(1)
Cellular Structural Functions of Phospholipids and Cholesterol---Especially for Membranes
848(1)
Atheroscelerosis
848(4)
Basic Causes of Atherosclerosis---The Roles of Cholesterol and Lipoproteins
850(1)
Other Major Risk Factors for Atherosclerosis
850(1)
Prevention of Atherosclerosis
850(2)
Protein Metabolism
852(7)
Basic Properties
852(2)
Amino Acids
852(2)
Transport and Storage of Amino Acids
854(1)
Blood Amino Acids
854(1)
Storage of Amino Acids as Proteins in the Cells
854(1)
Functional Roles of the Plasma Proteins
855(2)
Essential and Nonessential Amino Acids
855(2)
Obligatory Degradation of Proteins
857(1)
Hormonal Regulation of Protein Metabolism
857(2)
The Liver as an Organ
859(6)
Physiologic Anatomy of the Liver
859(1)
Hepatic Vascular and Lymph Systems
859(2)
Blood Flows Through the Liver from the Portal Vein and Hepatic Artery
860(1)
The Liver Functions as a Blood Reservoir
860(1)
The Liver Has Very High Lymph Flow
860(1)
Regulation of Liver Mass---Regeneration
860(1)
Hepatic Macrophage System Serves a Blood-Cleansing Function
861(1)
Metabolic Functions of the Liver
861(1)
Carbohydrate Metabolism
861(1)
Fat Metabolism
861(1)
Protein Metabolism
862(1)
Other Metabolic Functions of the Liver
862(1)
Measurement of Bilirubin in the Bile as a Clinical Diagnostic Tool
862(3)
Jaundice---Excess Bilirubin in the Extracellular Fluid
863(2)
Dietary Balances; Regulation of Feeding; Obesity and Starvation; Vitamins and Minerals
865(16)
Energy Intake and Output Are Balanced Under Steady-State Conditions
865(1)
Dietary Balances
865(1)
Energy Available in Foods
865(1)
Methods for Determining Metabolic Utilization of Proteins, Carbohydrates, and Fats
866
Regulation of Food Intake and Energy Storage
865(7)


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